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1、降糖治疗对糖尿病患者眼屈光度的影响作者:李海燕,罗国春,郭疆,梁真【摘要】目的:分析降糖治疗对糖尿病患者眼屈光度的影响。方法:新诊断的糖尿病患者20例,检测治疗前血糖、糖化血红蛋白(HbAlc)、空腹及餐后2hC肽。测定双眼屈光度、角膜曲率、前房深度及晶状体厚度,并在降糖治疗1,2,3,4wk分别复测以上眼部指标。分析屈光度改变与各生化指标的相关性及降糖治疗前后各眼部指标的变化。结果:降糖治疗后所有患者均出现远视性屈光改变,改变幅度与HbAlc和治疗lwk的降糖速度呈正相关,与治疗前血糖、空腹及餐后2hC肽无相关性,持续约2〜4wk逐渐恢复至治疗前屈光水平。治疗前后
2、,角膜曲率、前房深度和晶状体厚度等未见显著性变化。结论:降糖治疗导致糖尿病患者出现暂时性远视改变,改变幅度主要取决于治疗前HbAlc水平及前7d的降糖速度。其发生机制可能与晶状体水合化导致的屈光力降低有关,而非晶状体形态的改变。【关键词】屈光度;糖尿病;晶状体;血糖AbstractAIM:Toevaluatetheeffectsofglycemiccontrolonreffactionindiabeticpatients.METHODS:Twentynewlydiagnoseddiabeticpatientswereineludedinthisstudy.Thera
3、ndombloodglucose,HbAlclevels,fastingCpeptideandpostprandial2hCpeptideweremeasuredbeforetreatment・Thepatientswithrandombloodglucosehigherthan12.Ommol/LandHbAlclevelhigherthan10.0%wereselected・Refraction,intraocularpressure,radiusoftheanteriorcornealcurvature,depthoftheanteriorchamber,le
4、nsthickness,vitreouslength,andaxiallengthweremeasuredonadmissionandattheendofweek1,2,3and4duringglycemiccontro1.RESULTS:Atransienthyperopicchangeoccurredinal1thepatientsreceivingglycemiccontro1.Themaximumhyperopicchangewas1.60D(range0.50±3・20D).Recoveryofthepreviousrefractionoccurredbe
5、tweentwoandfourweeksafterinsulintreatment・TherewasapositivecorrelationbetweenthemaximumhyperopicchangesandtheHbAlclevelsonadmission(r=0.84,P<0.05).Therewasapositivecorrelationbetweenthemaximumhyperopicchangesandthedailyrateofbloodglucosereductionoverthefirst7daysofthetreatment(r=0.5
6、3,P<0.05).Duringtransienthyperopia,nosignificantchangeswereobservedintheintraocularpressure,radiusoftheanteriorcornealcurvature,depthoftheanteriorchamber,lensthickness,vitreouslengthandaxiallength.CONCLUSION:Transienthyperopicchangesoccurafterglycemiccontrolindiabeticpatientswithsev
7、erehyperglycemia・ThedegreesoftransienthyperopiaarehighlydependentonHbAlclevelsbeforetreatmentandtherateofreductionofthebloodglucoseleve1.KEYWORDS:refraction;diabetesmel1itus;lens;bloodglucoseINTRODUCTIONDuringhypoglycemictreatment,somediabeticpatientssufferfromblurredvision.Itiswel1k